In a recent study published February 2016 in the International Journal of Gynecology Obstetrics called “Multicenter analysis comparing robotic, open, laparoscopic, and vaginal hysterectomies performed by high-volume surgeons for benign indications,” Peter Lim, M.D., found that robotic-assisted benign hysterectomies performed by high-volume, experienced surgeons provided improved outcomes compared with abdominal, vaginal and laparoscopic hysterectomies.
According to Peter Lim, M.D., “It’s long been clear that minimally invasive hysterectomy can help reduce complications and speed recovery. But past studies comparing open and minimally invasive approaches compared less experienced robotic-assisted surgeons with colleagues in other approaches. This study is designed to compare only the outcomes of similarly experienced surgeons, regardless of surgical approach, which provides a much more accurate picture of comparative effectiveness.”
In other words, this new study compares surgeons of similar expertise and experience in order to gain an accurate understanding of surgical outcomes, whereas past studies compared experienced surgeons and much less-experienced robotic-assisted surgeons.
Studying more than 32,000 cases across the four surgical approaches at nine centers, Dr. Lim and his team compared 30-day outcomes from robotic-assisted hysterectomies performed by high-volume surgeons (more than 60 prior procedures) with data from high-volume surgeons obtained from the Premier Perspective database for abdominal, vaginal and laparoscopic hysterectomies.
For the study, the cases consisted of 2,300 robotic-assisted, 9,745 abdominal, 8,121 vaginal and 11,952 laparoscopic surgeries. The benign hysterectomy disorders were from Jan. 1, 2012 to Sept. 30, 2013.
According to Dr. Lim’s findings, patients undergoing robotic-assisted procedures “experienced significantly fewer intraoperative complications” than the abdominal or laparoscopic cohorts, and they had better outcomes and experienced fewer complications post-op as compared to those who underwent the abdominal, vaginal and laparoscopic procedures.
Another interesting finding was that despite the increased complications per individual case in the robotic-assisted surgeries, patients still had better results.
“Women in the robotic-assisted group had higher rates of obesity, adhesions and large uterus, suggesting that the robotic technology actually enables surgeons to perform surgery on more complex cases,” said Dr. Lim. “This study gives women and the surgeons who care for them important insights to inform their decision making.”